The Politics of Paying for Health Reform: Zombies, Payroll Taxes, and the Holy Grail

Publication Date:

Publisher: Center for Advanced Study in the Behavioral Sciences

Author(s): J. Oberlander

Research Area: Health

Type: White Paper

Abstract:

The process of paying for health care reform is influenced not only by financial and economic concerns but by political matters as well.



In this paper, the author reviewed relevant political factors in financing health care reform.



Key Findings:



Public and private sources provide funding for the current health care system in the United States. Obstacles to universal coverage include finding new revenue and the political impact of new taxes as sources of revenue.
Approaches to financing health reform are based on revising the tax code and could entail limiting employer subsidies, enacting employer mandates and/or a payroll tax, or implementing a value-added tax or sin taxes. There are political ramifications of each approach.
Other strategies to financing health reform include rolling back recent tax cuts, locating savings from existing programs that might yield new revenue, and mandating individual insurance. Political considerations exist for each strategy.A mixed system of financing health coverage in the United States will likely continue in the near future with options for health reform still grounded in employer-sponsored insurance programs. Being aware of the role of politics in financing coverage is important in understanding and crafting future health care reform efforts.